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Nursing homes' new goal for the 90's.

This nursing home chain revised its mission statement and its self-image

Are you part of a visionary organization? If so, who provides the vision in your organization - administrator, owner, multi-disciplinary team? Is the organization visionary, or is it simply an organization with visionary leaders? These may be the most important questions for any nursing facility to ponder. At Health Care Associates (HCA), a company that owns and operates twenty-one nursing homes, we began thinking about these questions by first looking at our existing mission statement. Like most other nursing home company mission statements, ours said that, "we strive to provide quality care and to assist each patient in reaching his/her optimum level of care." For the 80's, that was okay; for the 90's, it's only half the job.

In rewriting our mission statement, it became apparent to us that our existing statement merely described what we were doing. It wasn't especially stimulating or motivating. We also found that, in recent years, our nursing homes have been providing more sub-acute and rehabilitative services. These services were aimed at not only restoring people to their optimum level, but also returning them home.

For the 90's we wanted a statement that would motivate, excite and engage every employee to contribute extraordinary effort toward a common goal -- a mission that would stir controversy, as it should, but would, nevertheless, challenge us to improve further.

Our mission statement for the 90's?


Implicit in this statement is the achievement of quality care and optimum level of functioning. We believe that with appropriate home care services, every patient -- whether totally disabled, incontinent, needing assistance with feeding, or suffering from Alzheimer's -- should have the goal of returning home.

This mission statement is consistent with the Total Quality Management (TQM) program implemented last year at HCA. That is, we view TQM as a vehicle to accomplish our corporate mission of returning every patient home. One of the underlying philosophies of TQM is to provide what the customer wants, not what you may think he or she wants. What most patients in nursing homes have always wanted was to simply get better and go home.

In the process of looking at where we wanted to be in the 90's, we had to redefine other beliefs commonly held in the 80's; i.e. those referring to optimum level of functioning, luxury care, level of service, absentee ownership and the notion that it's reimbursable, so why not spend it.

In the 80's, nursing homes began providing "luxury care," with amenities like elegant dining and cultural activities directed at the well elderly. However luxurious the institution, the reality is that patients prefer noninstitutional settings, whether in their homes or in continuing care communities. While the intent of improving the quality of life with luxurious surroundings and fancy services is admirable, it runs counter to the mind-set of returning people home. As a result, we've modified the notion of luxury care by stating that, though a secondary objective of HCA is to offer the best quality of life while patients are with us, we never relent in our resolve to return patients home. Level of service in the 80's was determined by the provider; in the 90's it's the prerogative of the payor. Like the change from cost-related reimbursement in hospitals to DRG's, the change from cost-related reimbursement in nursing homes to case mix reimbursement puts the decision of the level of service to be paid for in the hands of state and federal regulators, managed care companies and insurance companies.

So, for the 1980's concept, "It's reimbursable, so why not spend it," the response today is simply, "We can't afford it." This is in line with our mission statement and TQM program of providing services only because they are needed, not just because they are reimbursable.

There are many overlapping philosophies in the notions of vision, mission, purpose and total quality management. However, there is one common thread -- the true measure success is the ability to serve true patient needs. Throughout the 70's, success was measured by providing good nursing care; in the 80's, it was achieving the optimal level of functioning. For the 90's, it's returning patients back home.

For the past 25 years, nursing homes have had an image problem. Although that image has greatly improved in recent years, most people still feel that nursing homes are a place where you go to die. I feel that it's time for this company to stop fighting the negative connotation associated with the nursing home label and, in fact, abandon it. These days HCA is much more than just homes that offer nursing. We are specialized facilities involved in sub-acute, rehabilitative, hospice, AIDS and home care. Between this and our new mission statement, we believe that we are on our way to becoming a true visionary organization. Brian J. Foley is President of Health Care Associates, an Avon, CT firm that owns and operates 20 health care facilities with 1,800 beds in locations throughout New England. He is also President of the Connecticut Association of Health Care Facilities.
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Title Annotation:Interview/Watch; Health Care Associates Inc.
Author:Foley, Brian J.
Publication:Nursing Homes
Date:Jan 1, 1994
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